key: cord-352329-dq69zlpn
authors: Gastélum-Cano, José María; Islas-Osuna, María A.; Arízaga-Berber, José Adán
title: Higher values of fasting blood glucose and glycated hemoglobin are not associated with mortality in Covid-19 Mexican patients
date: 2020-11-05
journal: Prim Care Diabetes
DOI: 10.1016/j.pcd.2020.10.014
sha: 
doc_id: 352329
cord_uid: dq69zlpn

nan

José María Gastélum-Cano 1 , María A. Islas-Osuna 1 , José Adán Arízaga-Berber 2* 1 Centro de Investigación en Alimentación y Desarrollo, A.C., Carr. Gustavo Enrique Astiazarán Rosas 46. La Victoria, 83304. Hermosillo, Sonora, México. 2 Hospital General Zona 4 del Instituto Mexicano del Seguro Social (IMSS).

Mutualismo and Río Lerma, 38060. Celaya, Guanajuato, México.

José Adán Arízaga-Berber dr.adanarizaga@hotmail.com Abstract: The SARS-CoV-2 has left a huge impact on death balance associated with COVID-19 around the world. There is a high proportion of these patients with diabetes, who have been documented to have more significant mortality and serious complication. Recently, abnormal fasting blood glucose (FBG) levels have been associated with increased death risk in Covid-19 patients. Besides, high HbA1c levels in those patients during admission, with diabetes or without as well. These results are associated with proinflammatory activity, prothrombotic states, and low levels of oxygen sa turation (SaO 2 ). Additionally, it has been observed a relationship between increased risk of mortality and higher levels of HbA1c. Thus, HbA1c has been proposed as a risk stratification marker. This work objective was to evaluate HbA1c as a complication and risk predictive mortality marker in patients with or without diabetes with Covid-19 at admission. A retrospective analysis of clinical and laboratory data obtained from Covid-19 patients at admission to intensive care services in the IMSS Hospital in Celaya, from August 13 to September 02, 2020. Statistical analysis was done by using twosamples Student t -test for continuous data and Aspin-Welch test when unequal variances. The χ 2 test for trend analysis resolved qualitative categorical data. Higher values of FBG and HbA1c in Mexican Covid-19 patients were observed, independently if they had been diagnosed with diabetes. However, this finding is not associated with higher mortality, and it is not necessarily dependent on respiratory complications but with prothrombotic activity. The SARS-CoV-2 has left a huge impact on death balance associated with COVID-19 around the world. There is a high proportion of these patients with diabetes, who have been documented to have more significant mortality and serious complications [1] . Type 2 diabetes mellitus (T2DM) is the most frequent among this disease spectrum. T2DM is characterized by β-cell dysfunction, insulin resistance, and a chronic pro-inflammatory process that culminates in micro and macrovascular complications. Diabetes is a capital health problem in México, where approximately one out of ten adults older than 20 years has this disease [2] .

Recently, abnormal fasting blood glucose (FBG) levels have been associated with increased death risk in Covid-19 patients [3] . Besides, high HbA1c levels in those patients during admission, with diabetes or without as well. These results are associated with pro-inflammatory activity, prothrombotic states, and low levels of oxygen saturation (SaO2) [4] . Additionally, it has been observed a relationship between increased risk of mortality and higher levels of HbA1c. Thus, HbA1c has been proposed as a risk stratification marker [5] . Nonetheless, the mechanism and clinical meaning of accelerated hemoglobin glycation in this phenomenon are uncertain yet. This work objective was to evaluate HbA1c as a complication and risk predictive mortality marker in patients with or without diabetes with Covid-19 at admission. 

for continuous data and Aspin-Welch test when unequal variances. Tukey's rule was applied for normalization when needed. The χ 2 test for trend analysis resolved qualitative categorical data. Results are shown in Table 1 .

In conclusion, there are indeed higher values of FBG and HbA1c in Mexican J o u r n a l P r e -p r o o f However, this finding is not associated with higher mortality, and it is not necessarily dependent on respiratory complications but with prothrombotic activity.

Possibly, the survival outcomes might depend on internal care protocol differences among hospitals. Thus, we suggest that the relationship between HbA1c and D-Dimers in patients with Covid-19 must be further analyzed. 

COVID-19 in people with diabetes: understanding the reasons for worse outcomes

Fasting blood glucose at admission is an independent predictor for 28-day mortality in patients with COVID-19 without previous diagnosis of diabetes: a multi-centre retrospective study

Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients

Unrecognized diabetes in critically ill COVID-19 patients